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Physiology revision Flashcards

1
Q

What spirometry results would you expect to find for a patient with COPD?

A

Decreased or normal FVC
Decreased FEV1
Decreased FEV1/FVC %

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2
Q

What spirometry results would you expect to find for a patient with interstitial lung disease?

A

Decreased FVC
Decreased FEV1
Normal FEV1/FVC%

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3
Q

What spirometry results would you expect to find for a patient with a combination of restrictive and obstructive lung disease?

A

Decreased FVC
Decreased FEV1
Decreased FEV1/FVC%

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4
Q

What is Boyle’s Law?

A

At any constant temperature, the pressure exerted by a gas varies inversely with the volume of the gas.

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5
Q

“As the volume of a gas increases, the pressure exerted by the gas decreases”. Who’s Law is this?

A

Boyle’s Law

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6
Q

What are the four steps of external respiration?

A

Ventilation
Gas exchange between alveoli and blood
Gas transport in blood
Gas exchange at tissue level

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7
Q

What two factors hold the thoracic wall and the lungs in close opposition?

A

The intrapleural fluid cohesiveness

The negative intrapleural pressure

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8
Q

What does the “intrapleural fluid cohesiveness” mean?

A

Water molecules in intrapleural fluid are attracted to each other and resist being pulled apart. Therefore, the pleural membranes stick together.

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9
Q

What does the “negative intrapleural pressure” mean?

A

The sub-atmspheric intrapleural pressure creates a transmural pressure gradient across lung wall and across chest wall. Therefore, the lungs are forced to expand outwards and the chest forced to squeeze inwards.

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10
Q

What is the average value for atmospheric pressure?

A

760mmHg

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11
Q

What is the average value for intra-alveolar pressure?

A

760mmHg

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12
Q

What is the average value for intrapleural pressure?

A

756mmHg

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13
Q

What nerves supply the diaphragm?

A

The phrenic nerve from cervical nerves 3, 4 and 5

C3, C4, C5

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14
Q

Is inspiration an active or passive process?

A

Active

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15
Q

Is normal expiration an active or passive proocess?

A

Passive

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16
Q

In a pneumothroax, what happens to the intrapleural pressure?

A 
It rises (to 760mmHg)
(Not 756mmHg anymore)
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17
Q

What is alveolar surface tension?

A

Attraction between water molecules at liquid air interface.

Produces a force which resists the stretching of the lungs.

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18
Q

What is the Law of LaPlace?

A

“The smaller the alveoli, the higher the tendancy for the alveoli to collapse.”

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19
Q

Which law states that alveoli with a smaller radius are more likely to collapse than alveoli with a larger radius?

A

The Law of LaPlace

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20
Q

What does pulmonary surfactant prevent?

A

The collapse of alveoli

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21
Q

What is pulmonary surfactant a mixture of?

A

Lipids and proteins

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22
Q

What is pumlonary surfactant secreted by?

A

Type II alveoli

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23
Q

How does pulmonary surfactant prevent collapse of alveoli?

A

PUlmonary surfactant lowers surfac tension of alveoli by interspersing between the water molecules lining the alveoli.
(Lowers surface tension of smaller alveoli more than that of large alveoli)

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24
Q

What is respiratory distress syndrome of the new born caused by?

A

Lack of pulmonary surfactant

because of premature birth

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25
According to alveolar interdependence, what happens if an alveolus starts to collapse?
The surrounding alveoli are stretched and then recoil, exerting expanding forces in the collapsing alveolus to open it.
26
What are the muscles of active respiration?
Internal intercostal muscles | Abdominal muscles
27
What is the value for: | Tidal Volume?
500ml
28
What is the value for: | Inspiratory reserve volume?
3000ml
29
What is the value for: | Inspiratory capacity?
3500ml
30
What is TV + IRV?
``` Inspiratory capacity (500+3000=3500) ```
31
What is the value for: | Expiratory reserve volume?
1000ml
32
What is the value for: | Residual volume?
1200ml
33
What is the value for: | Functional Residual Capacity?
2200ml
34
What is ERV + RV?
Functional Residual volume | 1000 + 1200 = 2200
35
What is the value for: | Vital Capacity?
4500ml
36
What is the value for: | Total lung capacity?
5700ml
37
What is VC + RV?
Total lung capacity | 4500 + 1200 = 5700
38
What is IRV + TV + ERV?
``` Vital capacity (3000 + 500 + 1000 = 4500) ```
39
VC =
IRV + TV + ERV
40
TLC =
VC + RV | IRV + TV + ERV + RV
41
IC =
TV + IRV
42
FRC =
ERV + RV
43
What is pulmonary compliance a measure of?
The effort that has to go into stretching or distending the lungs.
44
What causes decreased pulmonary compliance?
``` Pulmonery fibrosis Pulmonary oedema Lung collapse Pneumonia Absence of surfactant ```
45
What symptoms do patients with decreased pulmonary compliance present with?
Dyspnoea
46
Pulmonary compliance increases/decreases with age.
Increases
47
What happens if pulmonary compliance increases too much?
The elastic recoil of the lungs is lost
48
Increased pulmonary compliance is seen in:
Emhysema
49
With increased pulmonary compliance, patient have to work harder to..
Get air out of the lungs
50
How do you work of pulmonary ventilation (L/min)?
Tidal volume x Respiratory rate
51
What is the value for average pulmonary ventilation under resting conditions (L/min)?
6L/min
52
What is pulmonary ventilation?
The volume of air breathed in and out per minute
53
Why is alveolar ventilation less than pulmonary ventilation?
Because of the presence of anatomical dead space
54
How do you work out alveolar ventilation (L/min)?
(Tidal volume - Dead space) x Respiratory rate
55
What is alveolar ventilation?
The volume of air exchanged between the atmosphere and the alveoli per minute
56
What is anatomical dead space?
Areas of respiratory tract containing air that does not reach the alveoli and is therefore not involved in gas exchange between the atmosphere and the alveoli.
57
What is alveolar dead space?
Ventilated alveoli which are not adequately perfused with blood.
58
What is physiological dead space?
Anatomical dead space x Alveolar dead space
59
What is ventilation the rate of?
The rate at which gas passes through the lungs
60
What is perfusion the rate of?
The rate at which blood passes through the lungs
61
Sympathetic stimulation causes bronchodilation/bronchoconstriction.
Bronchodilation
62
Parasympathetic stimulation causes bronchodilation/bronchoconstriction.
Bronchoconstriction
63
Bronchodilation is caused by sympathetic/parasympathetic stimulation.
Sympathetic
64
Bronchconstriction id caused by sympathetic/pararsympathetic stimulation.
Parasympathetic
65
When oxygen is decreased, the pulmonary arterioles vasodilate/vasoconstrict.
Vasoconstrict
66
When oxygen is decreased, the systemic arterioles vasodilate/vasoconstrict.
Vasodilate
67
When oxygen is increased, the pulmonary arterioles vasodilate/vasoconstrict.
Vasodilate
68
When oxygen is increased, the systemic arterioles vasodilate/vasoconstrict.
Vasoconstrict
69
Which four factors influence the rate of gas exchange across an alveolar membrane?
Partial pressure gradient of oxygen and CO2 Diffusion coefficient for O2 and CO2 Surface area of alveolar membrane Thickness of alveolar membrane
70
What is Dalton's Law of Partial Pressure?
The total pressure exerted by a gaseous mixture = the sum of the partial pressures of each individual component in the gas mixture
71
What is PAO2?
Partial pressure of O2 in alveolar air
72
What is PiO2?
Partial pressure of O2 in inspired air
73
PaCO2
Partial pressure of CO2 in arterial blood
74
What is the value of the respiratory exchange ratio?
0.8
75
What is the respiratory exchange ratio?
The ratio of CO2 produced/O2 consumed | 0.8
76
What is the O2 partial pressure gradient in pulmonary capillaries? (from alveoli to blood)
60mmHg
77
What is the CO2 partial pressure gradient is pulmonary capillaries? (from blood to capilaries)
6mmHg
78
What is the O2 partial pressure gradient in systemic capillaries? (blood to tissue cells)
>60mmHg
79
What is the COs partial pressure gradient in systemic capillaires? (tissue cells to blood)
>6mmHg
80
Why is thee partial pressure gradient so much higher for O2 than CO2?
Because the diffusion coefficient is (20 times) higher for CO2 than O2. (solubility of gas in membrane, much higher for CO2 than for O2)
81
A big gradient between PAO2 and PaO2 would indicate:
Problems with gas exchange in the lungs or A right to left shunt in the heart
82
What is Fick's Law if Diffusion?
"The amount of gas that moves across a membrane in unit time is proportional to the area of the sheet but inversely proportional to its thickness"
83
Which law states that as thickness of a membrane increases, the amount of gas moving across is decreases?
Fick's Law of Diffusion
84
Which law states that as the area of a membrane increases, the amount of gas moving across it increases?
Fick's Law of Diffusion
85
Under resting conditions, how much oxygen is taken to the tissues as dissolved O2?
15ml/min
86
At strenuous exercise, how much oxygen is taken to the tissues as dissolved O2?
90ml/min
87
What is the resting oxygen consumption of our body cells? (ml/min)
(approx.) 250ml/min
88
How many haem groups does each haemoglobin contain?
4
89
What is DO2I?
Oxygen Delivery Index
90
What is CaO2?
Oxygen Content of arterial blood
91
What is CI? | ci
Cardiac index
92
How do you determine the oxygen delivery index?
DO2I = CaO2 x CI
93
How much O2 does one gram of haemoglobin carry when fully saturated?
1.34ml
94
How do you determine the oxygen content of arterial blood?
``` CaO2 = 1.34 x (concentration of Hb) x SaO2 (1.34 = how much oxygen one gram of Hb carries when fully saturated) (SaO2 = % Hb saturated with oxygen --- determined by PO2) ```
95
What is thee pressure of the water vapour in the respiratory tract?
47mmHg
96
What is co-operativity with regards to Hb?
Binding of one O2 to Hb increases the affinity of Hb for O2
97
What is the Bohr Effect?
Shift of (dissociation) curve to the right
98
What is the name of the effect when the (dissociation) curve shifts to the right?
The Bohr Effect
99
Foetal Hb has a higher/lower affinity for O2 than adullt Hb
Higher
100
The foetal (dissociation) curve is shifted to the left/right compared to the adult curve
Left
101
Myoglobin has ___ haem group(s).
1
102
Myoglobin provides a shirt-term storage of O2 in which conditions?
Anaerobic
103
The presence of myoglobin in the blood indicates
Muscle damage | cardiac or skeletal
104
The rhythm of breathing is generated by a network of neurons called the..
Pre-Botzinger complex
105
What respiratory group of neurons are excited by the pre-botzinger complex and then fire in burts, causing contraction of inspiratory muscles?
Dorsal respiratory group neurons
106
What respiratory group neurons are excited by increased firing of dorsal neurons?
Ventral respiratory group neurons
107
Stimulation of the _______ centre terminates inspiration.
Pneumotaxic centre
108
The pneumotaxic centre is stimulated when _____ respiratory neurons fire
Dorsal respiratory neurons
109
Breathing rhythm generated in the...
Medulla
110
Breathing rhythm can be modified by inputs from...
Pons
111
What is the Hering Breuer reflex?
Afferent discharge (pulmonary stretch receptors) inhibits inspiration
112
What do chemoreceptors do?
Sense the valus of the gas tensions

Respiratory Physiology (2 decks)

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